DESCRIPTION: (Adapted from the Application) The purpose of the applicant is to develop a health literacy assessment tool for the Spanish-speaking population. Specifically, the applicant is intended to validate an assessment tool to be developed based on the Rapid Estimate of Adult Literacy in Medicine (REALM), which is known to be the most efficient and easily administered tool to assess health literacy in English. The validation of the new assessment tool, which we term the Spanish Rapid Estimate of Adult Literacy in Medicine (S-REALM), involves testing and comparing the tool with other health literacy assessment instruments in a sample of 200 Spanish-speaking and 200 English-speaking subjects to be recruited from the Ambulatory Care Center at the University of North Carolina Hospitals. The past several years have witnessed a growing societal concern with low health literacy and its health toll. Research has shown that low health literacy may be associated with low health status and increased rates of hospitalization. Given the rapid growth of Hispanic residents in our nation, the development of a reliable and easy-to-use health literacy assessment tool in Spanish cannot be overemphasized. We anticipate that the S-REALM will take about 5 minutes to administer. Therefore, health professionals can use it in clinics and public health settings to assess the health literacy level of Spanish-speaking patients. This will enhance health professionals? ability to communicate with, and, thus, deliver better medical services, to Spanish-speaking patients. Moverover, the S-REALM can be used as a health literacy screening tool in local Hispanic communities. The result will improve our understanding of the specific health and personal needs of Hispanic residents and help policy makers, researchers, and community groups design intervention and educational programs that suit the health literacy level of this under-served population.